I had a good nursing session with Henry in the morning (11AM). It is always a production getting him latched, but once latched, he did a good job nursing. He is rather slow about it, but that's fine. It means that he's not gulping down the milk and then choking and then having bradys. I've also changed my nursing strategy so that, like yesterday, I pump 30 minutes to 1 hour before nursing, so that he doesn't get flooded. I nursed him again at 2PM, but he kept losing interest. Over 35 minutes, I don't think that he nursed more than 9 minutes. I asked Joyce to give him some of the milk via the NG tube She gave him 1/4 of a feeding.
My mom came in the afternoon, which worked out because Jeff and I needed to go shopping. We hadn't made any nursery purchases yet (we thought that we'd have the summer to do it). We ended up going to Aldrich's on the east side of town and buying a lovely crib made of cherry wood (real wood rather than wood veneer). It's a nice looking piece of furniture. The downside was that it didn't have a matching dresser, so we'll have to figure out that one later. We also bought a good mattress, a bath tub, a diaper genie, and a portable diaper changing station. We're holding off the the stroller and car seat until we do some research. Our friend Laura (who has two children--one of them born a few weeks after Henry but was five times Henry's size!) gave me some suggestions in May that I plan on looking into. She had a great stroller for her eldest child Finn that was very smooth over cobblestone. I figure that it would probably work well in our neighborhood (we don't have cobblestone, but we have a dirt road that would probably have a similar effect on a stroller). If anyone has car seat or stroller suggestions, Jeff and I would love to hear them.
Jeff dropped me off at the hospital after shopping and dinner. He's still holding off on seeing Henry because he's not sure whether he's getting sick or has allergies. I can count the number of times that Jeff has been sick since I've known him. It's pretty darn rare, but playing it safe is best for Henry (and the other NICU babies).
When I arrived in the NICU, Kathy had just changed Henry's diaper and was weighing him. Henry was very upset and all worked up. He weighed 1830 grams (up 15 grams from last night). I tried nursing, but Henry was "disorganized" in his behavior. He was rooting and crying but couldn't seem to get it together to latch. It was very frustrating, considering that we'd had such a good day nursing. He's still a pretty sensitive little fellow. I think that the noise of the NICU (it has been really loud lately, with both controllable (adult) and uncontrollable (baby) sounds) was getting to him. By the time we got him settled to nurse, he was upset and then finally so worked up that he wore himself out. After half an hour, I got up to tell Kathy that we'd have to give him a feeding through the NG tube. In the process, I got caught on the cannula tube and disconnected it from the oxygen canister. I couldn't find Kathy initially (she was getting bottles for another mother), so I asked Chris to help me out. The good news is that even when disconnected from the oxygen, Henry didn't dip below the acceptable oxygen saturation threshold. .075 liters isn't much, but he still needs it for long stints, I think. Kathy said that when they are that low, a couple minutes might not matter, but he'd probably have trouble for longer periods time without the whiff of oxygen blowing into his nose. Kathy got his feeding for him, and I held Henry on my chest (kangaroo style).
Henry did well on my chest. Just before the end of Kathy's shift when Holly had just arrived, Henry had a brady that required a bit of stimulation from me. He was really in the zone sleeping. And, I think that it was one of those bradys caused by him being too relaxed. As near as I can tell, bradys can be brought about by three things: (1) general weakness in breathing, where the lack of breathing then causes the heart to stop or slow down, (2) being too relaxed, such that the heart forgets that it needs to pump, and (3) a vagal response brought about by bearing down, reflux in the throat, or tubes in the throat (e.g., when Henry had the replogle tube down his throat). These days, Henry's bradys tend to be caused by reflux. But this last one, I'm pretty sure, was due to being way too relaxed on my chest.
I think that Henry missed his dad today. When he was on my chest, he kept trying to grasp at it, like he does to Jeff's chest hairs. Alas, I had no chest hairs to grab (thank goodness).
Holly held a party in Henry's honor. She brought in a carrot cake, sparkling cider, and ranier cherries to celebrate Henry breaking the four pound mark. Kathy got a piece of cake before she left. Hans stopped by. He'd been by earlier trying to help Holly open the sparkling cider bottle. It wasn't budging; at one point they were trying to use tongs, but that didn't work so well. Nadine, Sue, Mary Ann, and some others also stopped by to see Henry and have some cake. Holly wanted me to bring home Jeff a piece of cake. Unfortunately, she couldn't find saran wrap, so she ended up putting the cake in a clean biohazzard bag, which I found amusing.Jeff and I are scheduled to meeting two pediatricians tomorrow for "meet and greets" (one at 8AM and one at 12:30PM). All pediatricians that we are considering have been recommended by someone. Without knowing them, the downside to our 8AM doctor is that she just received her degree in 2006, and we aren't sure that an inexperienced doctor would be good for Henry (because he may have special needs that need to be identified as soon as possible). The disadvantage to the 12:30PM doctor is that his office is in the hospital, which means sitting in a large waiting room with a bunch of sick people before appointments. We have heard, however, that the doctor has extensive experience with kids with disabilities (in part due to the fact that his patients include a lot of low income persons who come to the hospital for their primary care). The doctor that Jeff talked to on the telephone yesterday said that he's been a pediatricians for 24 years; he's worked with "extremely low birth weight" (ELBW) preemies before; he's on our side of town; and he has two waiting rooms (one for sick kids, and one for kids needing check-ups). He called Jeff before he went on vacation, so we'll have to see when he is getting back.
We've put together a list of Henry's issues to date:
* ELBW and SGA (small for gestational age) due to IUGR (intrauterine growth retardation); born 1 lbs 4 oz at 25 weeks gestational age
* chronic lung disease
* had hyperbilirubinemia, which was resolved the first week under the bili lights
* had a PDA or patent ductus arteriosus, but it closed with medication
* came off ventilator quickly, but still requires oxygen assistance via cannula
* currently weighs 4 lbs 1/2 oz at 37 weeks gestational age
* may have had NEC; was treated for NEC
* had slight brain bleed in the cerebellum; appears to have been resolved; unclear whether it was a true bleed or a measurement artifact
* has bilateral hernias that will require an operation before he leaves the NICU
* retinopathy of prematurity Stage 2 in Zones II and III of both eyes
* anemic with hematocrit level at 26.5
* has good muscle tone
* beginning to breast feed, but most feeds are done through his NG tube
* heart murmur
* has metabolic bone disease
* noise sensitive
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